HomeMy Public PortalAbout9557BISBY ST_Plumbing (5) T
-APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFfftTY DIVIAION
FOR APPLKANT TO FILL IN(PRINT OR TYPE) DING
NUMBER FIXTURE OR ITEM • FEE Dom$ `7 T
WATER CLOSET �TM 1
11ATHTUB0 CRASS 57NEAREST
.
SHOWER OWNER Q
LAVATORY eQS -y T f -
SINK QTY TFL NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO.
LAWN SPRINKLER SYSTEM
STATE U UC
WATER HEATER V LK:ENSE NO. CLASS
GAS SYSTEM O ✓� DISTRICT NO, GROUP BY
k5 O Z
INDUSTRIAL
WASTE APPROVAL CC
INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTALFEE
Plan che&applicant
APPROVALS DATE INS?ECTD Rs 1WG NATURE
Name
LIN DE R SLAB WORK
Address ROUGH PLUMBING
city Tel.No. GAS PIPING
I HEREBY A"NOWILIMM THAT I HAVI F7,AD THIS APPLICATION AND STATE GAS VENT
THAT THE AEOYE t5 CORREcT NTD AGM TO COMPLY werH ALL COUNTY OIsDINAW" HOT WATER HEATER
NO STATE LAMS IUMMATI Ra PLUYEI NG. .. .-,
I HERESY cERTIMY THAT I w rROrmtLY mmTLRED Nm/dR L.ICIIfSdD A5 PLUMBING FIXTURE
REM RID BY LM ANG In COU NTT AND STATE:OF CALFORNM OR THAT I AY THE GAS TEST
LEGAL OWNER Or,AM WMWD TO RESIDE IN THE ABOVE DCiCRIEID RKSIDENTIAL
PRDrERTY. UTI LTTY 00.NOTI FIED
BIO IIATU RI ,
Or PERAIITI CC FINAL
PLAN CHECK VALIDATION cx r o. PERMIT VALIDAT1dN cx hLo. CAM
16 8 r"_'JAH 19 5 D 1 6.5 0 aS3